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ijave Neceiveo ob/io/9,3 <br /> Site Code : 1988 <br /> Site Name: HOLT BROTHERS INC Lead <br /> Address: 1541 W CHARTER WY Contact : <br /> City: STOCKTON Zip: 95206 Phone : <br /> Billing/responsible Party Information <br /> T <br /> Billing Name : Bill Info OK? <br /> Address : <br /> City : Zip: <br /> Contact : Phone <br /> Property Owner/Operator <br /> Name : 9hone: <br /> Address : <br /> City: Zip: <br /> Client Information (if different from Owner/Oper I ator) <br /> Name: Phone -. <br /> Address : i <br /> City.- SI late: Zip: <br /> Applicant' s namey date signed, title <br /> Name : Date. <br /> Title: <br /> Consultant Company : RESNA <br /> Contact Name .- Phone - <br /> Other Contact name or Info : Phone: <br /> Program Element : 3526 Billing Code* Assigned To: ML <br /> T '} <br /> Title of Submittal : QMR <br /> Date of Submittal : 05/06/93 1 OT Request : Ni OT Request Date : <br /> ........... <br /> Type of Submittal : 9 Quarterly Report/Post—Remedial Monitoring <br /> Permit Fee Paid 0. 00 <br /> Check No. /Cash <br /> Date Paid <br /> Permit Fee Paid 0. 00 <br /> Check No. /Cash <br /> Date Paid <br /> Staff Review Due : OT Scheduled: OT Completed : <br /> Action Date Action Dalt e Action Date <br /> Ack/Com Ltr Req Add. Info R td Srp Due <br /> Ack/Com Ltr Reed Revisione , TV PR Due <br /> RWQCB Comments Repor ar Due <br /> Othr Agency Appr File N A FRP Due <br /> Info Recvd Deni Reyinion- Due <br /> Permit Type : Special P s - 0th Agency Due <br /> Wrkpin Revw Comp Comment r nt Project Complt <br />